App Review: Eko Stethoscope

The stethoscope celebrated its 100^th anniversary last year and has continued to remain one of the most essential and recognizable tools of medical practice, even as much has changed in that same time frame. Despite the central role this device plays in daily medical care, very little has been done to enhance or increase its functionality – until recently.

Rating

Pros: Excellent recording functionality, ability to share recordings 

Cons: Slightly bulky, requires intermittent charging

The unit is fairly heavy and will feel much bigger/bulkier to individuals used to a traditional stethoscope model. That being said, the unit itself is fairly simple to operate, possessing a push-through rocker that turns the digital amplification and app connection on or off as well as a button rocker to control the level of amplification. There is also a small port covered by a rubber grommet that allows charging of the device (with a full charge, the Core will work for about a week with regular daily usage, based on my tests). If the unit is off, the stethoscope will still work in what the company refers to as ‘analog mode.’ Once turned on, the unit provides digital amplification and the ability to record auscultated sounds as waveforms to a physician's device.

The Eko Core is the latest in a line of devices designed to use both enhanced technology and medical app functionality to deliver a superior product. At the heart of the system is the Eko Core itself – a typical looking stethoscope with one particular enhancement – the addition of a bulbous digital unit that attaches to the supplied stethoscope tubing. This unit can be purchased separately and added to almost any other stethoscope as well, as it sits in line with the tubing leading to the earpieces and the diaphragm/bell.

It's in the app that the advantages really come through. The app is very effective in displaying and recording waveforms as well as replaying those waveforms through the stethoscope or on your mobile device. The process of recording and playback has improved considerably with the latest version of the app, as has securely accessing the app via Touch ID or 4-digit security PIN. The app also allows the user to integrate recordings into certain EHRs, although the list is currently very slim (only drchrono and Eclinicalworks were listed). Recordings can be stored on Eko's cloud servers and shared via web access with other users.

In practice, I found the Core stethoscope to be easy to use and record with. The digital amplification is almost too sensitive and can sound very shrilly at times, but a physician is able to auscultate heart and lungs sounds as well as (if not better) with practice. The recording feature is very interesting and, as a teaching physician, I find it very useful to be able to play back both heart and lung sounds of patients with specific disease manifestations. Overall, I liked using the Core and plan to replace my regular stethoscope (which was significantly more expensive) with it.

Interestingly, the company is coming out with a new product called the Duo which will function as both a stethoscope and single lead ECG. The app will allow the user to see an electrical lead in real-time paired with an audio waveform recording. The device has not been released yet, but I am intrigued to see how this may enhance a physician's ability to evaluate heart conditions in the ambulatory setting.

The Eko Core and its accompanying app set a new standard for auscultation and I believe that it is a functional combination that is worth the entry price, $199 for the Core attachment or $299 for the Core Attachment and stethoscope combo. I suspect we will see more products come into this market soon and it will be interesting to see how this once-steady medical tool continues to morph in the future.